Accuracy of Ultrasound Scans as Compared to Fine Needle Aspiration Cytology in the Diagnosis of Thyroid Nodules

Abstract

Introduction: Thyroid nodules (TNs) are among the more common findings on physical examinations. Due to the fear of the TN harboring malignancy and with the increasing incidence of thyroid cancer, ultrasound (US) scanning is used as an important diagnostic tool in the assessment of a TN. The American College of Radiology's Thyroid Imaging Reporting and Data System (TI-RADS) was established based on specific patterns composed of two or more features. According to the TI-RADS guidelines, a suspicious nodule by US findings should undergo fine-needle aspiration cytology (FNAC), in which results would guide further management.Objective: This study was carried out to assess the accuracy of US as compared to FNAC in the diagnosis of a thyroid nodule.Methodology: This retrospective study involved 213 cases that were sent for FNAC after having done a US scan of the thyroid. Data was gathered from all patient files that were referred for FNAC thyroid between 01/02/2018 and 30/06/2021 in Al-Ahli Hospital in the state of Qatar. The US scans were interpreted and reported according to the TI-RADS criteria. The FNAC samples were interpreted and reported according to the Bethesda System for Reporting Thyroid Cytopathology. Data were tabulated and analyzed with Excel (Microsoft, Redmond, WA, USA) and SPSS version 25 (IBM Corp., Armonk, NY, USA).Results: The study showed that US had a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 73.9%, 72.6%, 24.6% and 95.8%, respectively, with a significant association between the results of US and the results of FNAC (X 2 (1, n = 213) = 20.295, p < .001) and a significant positive correlation (phi coefficient = .309, p < .001). In addition, the data showed that the odds for having a positive FNAC were 7.519 (95% CI: 2.811, 20.112) times greater for cases with positive US compared with cases with negative US. The relative risk of having a positive FNAC when the US was positive was 5.913 (95% CI: 2.440, 14.332) times greater compared to when the US was negative.Conclusion: While our results showed that US cannot be solely relied on in diagnosing TNs, they did show that US can reliably rule out a malignancy in TNs. Recent studies have been showing increasing accuracy of US in diagnosing TNs and more studies are needed to explore this topic.

Diagnostic value of ultrasound-guided fine-needle aspiration cytology in the pathological natures of thyroid nodules: A retrospective study

“…Fine-needle aspiration cytology and ultrasonic examination are key tools for pre-operative evaluation of patients with thyroid lesions. [ 18 - 20 ] Ultrasound examination provides a reference for nodular selection in US-FNAC. Ultrasound guidance assists physicians in seeking a more accurate puncture path and the best puncture position, thus effectively avoiding blood vessels and nerves and improving the success rate of puncture while ensuring safety.…”

Malignancy Rates in Thyroid Imaging Reporting and Data System Category 3 (TI-RADS 3) Thyroid Nodules: A Retrospective Study

“…The incidence of thyroid cancer has been climbing steadily, a trend that is particularly pronounced among younger adults. In the United States, for instance, thyroid cancer stands as the most prevalent cancer in men aged 30 to 39 and the second most common in women of the same age group [ 2 ]. This evolving pattern prompts inquiries regarding environmental, genetic, or diagnostic contributors to this rise.…”